Chong K C, Vojnic C D, Quanbury A O, Letts R M
Clin Orthop Relat Res. 1978 May(132):145-50.
A study of 12 cerebral palsied children with internal rotation revealed three patterns of electromyographic activity: (1) Diagnostic pattern--where a simple muscle group stood out as the responsible agent--notably the medial hamstrings; (2) Nondiagnostic pattern--nonrecurring pattern; (3) Nondiagnostic pattern--recurring "mass limb reflex" pattern. In all cases, electromyography was useful for: (1) confirmation of clinical impressions. Electromyographic confirmation of phasic hamstring overactivity gives a firm basis for tendon surgery with expectancy of good results. (2) Detection of the responsible muscle group where clinical methods fail to do so. It detects the "at risk" patients, where follow up with tendon surgery at the appropriate time could be performed with predictable results. (3) Selection of patients who are likely to respond to tendon surgery, and those unlikely to benefit from it. The adductors and internal rotators may play only a secondary role in children whose predominant problem is internal rotation during gait. The medial hamstrings stand out as the most important single muscle group causing this problem. Consequently, it is important to analyze gait problems with the patient walking, and examine electromyographs during walking in the overall assessment of a patient with dynamic gait problem.
一项针对12名存在内旋问题的脑性瘫痪儿童的研究揭示了三种肌电图活动模式：（1）诊断性模式——即某个单一肌肉群明显为责任因素——尤其是半腱肌内侧头；（2）非诊断性模式——非重复性模式；（3）非诊断性模式——反复出现的“肢体总体反射”模式。在所有病例中，肌电图检查在以下方面很有用：（1）证实临床印象。肌电图证实的股后肌群阶段性过度活动为肌腱手术提供了坚实基础，预期会取得良好效果。（2）在临床方法无法做到时检测出责任肌肉群。它能检测出“有风险”的患者，对这些患者在适当时候进行肌腱手术随访可获得可预测的结果。（3）挑选可能对肌腱手术有反应以及不太可能从手术中获益的患者。在步态中主要问题是内旋的儿童中，内收肌和内旋肌可能仅起次要作用。半腱肌内侧头是导致该问题的最重要单一肌肉群。因此，在对有动态步态问题的患者进行全面评估时，让患者行走并在行走过程中检查肌电图来分析步态问题很重要。
